Children at the San José Obrero School use the primary school's computer lab. At their homes in the municipality of Peñalolén, to the east of Santiago de Chile, many do not have computers because 90 percent of them come from poor families. CREDIT: Courtesy of San José Obrero

By Orlando Milesi
SANTIAGO, Jul 1 2022 (IPS)

A Chilean government plan seeks to ensure connectivity in remote areas, in a first step to address a deep digital divide among the country’s inhabitants that includes a lack of access to technology and digital education deficits, exposed by the COVID-19 pandemic.

In 2020, during the social isolation at the height of the pandemic, 76 percent of children in higher income segments had their own computer, laptop or tablet and 23 percent had access to a shared one.

But in the lowest income segments, only 45 percent of children had their own computer or laptop, while 16 percent had none. The rest managed to get access to a shared computer or tablet.

There are also notable differences according to the type and location of schools.

One school that illustrates the gap

“People here don’t have computers, although it may seem strange,” said Cecilia Pérez, principal of the San José Obrero School in Peñalolén. “Computers are just a dream for many. Nor do they have their own connection, or wi-fi. They have cell phones with prepaid minutes or very cheap plans that do not give them a good enough connection to support a lesson.”

In a conversation with IPS at the school, she said “this is a disadvantage that has nothing to do with the children’s desire to study, their intelligence, or their worried families. It is something external that is difficult to solve.”

To illustrate, Pérez said that “if homework is posted on the platform, it is very hard for children to read it and do it from their cell phones.”

Her school is in a poor neighborhood located at the end of Las Parcelas Avenue, in the Andes foothills of Santiago, the capital. Most of the first to eighth grade students come to school on foot.

At the San José Obrero School in the municipality of Peñalolén, in the foothills surrounding the Chilean capital, 90 percent of the students come from poor families, with parents who work as street vendors, cleaners or similar trades. Parental support for homework is almost non-existent, says the principal of the primary school, Cecilia Pérez. CREDIT: Orlando Milesi/IPS

This public primary school in the municipality of Peñalolén, which serves 427 students, is an example of the connectivity problems faced by students in the most deprived urban and rural areas.

In this South American country of 19 million people, there are 3.6 million primary and secondary students. Two million students are enrolled in the first to eighth grades (six to 13 years of age) and the rest are in secondary school (13 to 17 years of age).

Of the total number of students, 53 percent study in state-subsidized private schools, 40 percent in municipal schools and seven percent in private schools.

“We have third grade students today who started first grade in 2020, at the height of the pandemic, when they had to learn to read and write. These children had only gone to kindergarten and are now coming to class in the third grade with a very significant delay,” she said, referring to the effects of distance learning during the pandemic.

Because of this, Pérez said, “we had to set priorities in the curriculum and reinforce language and math which are super important to continue learning.”

She added that another serious problem is that many of their students experience situations of domestic violence. “Their emotional and social support is the school, and when they couldn’t be with their classmates, they lost two years of socializing,” she said.

“We have children between the fifth and eighth grades who have experienced a lot of violence, a lot of individualism, a lot of sexualization that never happened before. Partly because there is no parental control over cell phones at home,” she said.

An additional problem is connectivity because in Peñalolén “there are many hills and in some parts the internet does not work. There are families who returned the ‘router’ (a device that receives and sends data on computer networks) that we lent them because the signal does not reach their homes.”

Older children at the San José Obrero School in the municipality of Peñalolén, near Santiago de Chile, stay two hours longer at the school, doing sports and other activities as part of their education. In this way they avoid excessive leisure time and a lack of supervision at home, which can be dangerous for them. CREDIT: Orlando Milesi/IPS

Tackling inequality

The deep digital divide among Chileans is aggravated by the difficulties in accessing the internet in isolated villages, rural localities and also in poor urban neighborhoods where telecommunication companies do not provide service or where criminals steal the cables.

“Inequality in our country is also manifested in internet access,” said leftist President Gabriel Boric, in office since March. “Thousands of students were unable to exercise their right to education during the pandemic due to a lack of connectivity.”

To address this situation, he said in a recent communiqué, “our Zero Digital Divide Plan will ensure, by 2025, that all the country’s inhabitants have access to connectivity.”

“This requires a sustained effort to continue with current initiatives such as the Internet as a Basic Service Bill and the generation of new projects that will allow us to reach isolated and rural areas,” he said.

As an example, Boric mentioned the town of Porvenir, which a month ago became the southernmost part of this long narrow South American country with access to the 5G network.

The 36-year-old president won the elections in the wake of the huge 2019 protests, in which one of the demands was to end the social inequality gap, one of the largest in the world according to international organizations, and where more equitable access to education was one of the main points.

Paulina Romero, a first-year chemistry and pharmacy university student, became a symbol of the digital divide that Boric seeks to eliminate, when two years ago images of her climbing onto the roof of her house in the small community of San Ramón, in the southern region of La Araucanía, in a dangerous attempt to find a signal to be able to do her assigned homework, went viral.

A colorful mural decorates the staircase leading to the second story of classrooms at the primary school in Peñalolén, located in the snowy Andes foothills seen here in the background in the middle of Chile’s southern hemisphere winter. CREDIT: Orlando Milesi/IPS

Plans to close the gap

Claudio Araya, undersecretary of telecommunications, told IPS that all efforts are focused on improving connectivity.

“A bill was approved in Congress a month ago that guarantees internet access for students,” he said. He pointed out that in part this access already exists but it is not operational for schoolchildren, because “many students in areas with coverage had problems with distance learning because their families could not afford cell phone plans.”

Araya added that a project is being implemented to ensure that all public schools, whether run by municipalities or the State, as well as subsidized private schools, have coverage for remote areas and connection speed.

“One part of the project is being completed now, by August, for 8,300 schools, a second part with 500 more by March 2023, and a third with a call for bids before 2023, which will cover just over a thousand schools,” he explained.

His office has also allocated resources for a new project, called “last mile”, which seeks to bring connectivity to isolated or rural areas. “We have already invested some 200 million dollars and we are contemplating an additional 150 million dollars to provide service coverage to the communities,” he said.

There are 40 computers available at the San José Obrero School for the children to search for information and complete their learning in various subjects under the supervision of the teacher in charge. But there is no possibility of laptops that they can take to their homes, where most of them have no computers. CREDIT: Courtesy of the San José Obrero School

Another school stumbling over connectivity issues

Connectivity is the main problem for the 73 students at the school in the small town of Samo Alto, in the Andes foothills area of the municipality of Rio Hurtado, 440 kilometers north of Santiago.

“We are educating 21st century children with 20th century resources and technology,” Omar Santander, principal of the primary school, told IPS by telephone.

“The connection to the global world does not exist. You turn on a computer, log on to the network and all the other computers disconnect. It is impossible to work online. We have computers and tablets, but there they are, and they can only be used with resources and programs downloaded ad hoc,” he said.

The students cannot communicate and “these are gaps that keep us from providing greater opportunities,” he said.

“The lack of computers is the smaller problem. We have achieved internet efficiency and we have the equipment. The big problem is connectivity,” Santander stressed, adding that an antenna they made to capture the signal was not enough.

He said that “last year when we held hybrid classes, half at home and half at school, one day we tried to connect and it was a terrible disappointment.

“There is a wealth of information, of pedagogical resources available to students that unfortunately we don’t have access to,” Santander complained.

The principal explained that “everything that has to do with access to resources that enrich reading, writing, calculus and mathematics is there and we cannot make use of it.”

From the San José Obrero School, Santiago de Chile can be seen in the background, under a cloudy sunset after a recent rain on the first day of the southern hemisphere winter in Chile. CREDIT: Orlando Milesi/IPS

More than internet access

Luciano Ahumada, head of the School of Informatics and Telecommunications at the Diego Portales University, said that “reducing the digital divide goes far beyond having an internet plan.”

“It also involves promoting the use and daily impact of information and communications technologies (ICTs) to maximize people’s well-being. It is a much more complex and time-consuming challenge than access,” he told IPS.

In his view, “we must work on access, but also on economic, ethnic and gender barriers and establish a framework concept of cybersecurity or basic concepts in the population to live in a healthy way in this new world.

“There is an economic gap, an age gap, an ethnic gap, which in different countries has become very evident,” he said.

Ahumada said that “access is just the starting-point. It is a good initiative, necessary to massify internet access, but we must think about massification of high-speed connections because with networks of the past we cannot carry out actions of the future and establish the basis for an information society.”

Doris Martínez gets ready to start cooking at her food kiosk in Valles del Tuy, an area of small dormitory towns near Caracas. CREDIT: Humberto Márquez/IPS

By Humberto Márquez
CARACAS, Mar 18 2022 (IPS)

Doris Martínez was a cook in a Venezuelan restaurant that closed its doors; she emigrated to Colombia, got sick from working long hours standing in front of a stove, and returned to her country where, together with her husband and children, she runs a busy fast food kiosk on a road in Valles del Tuy, near the Venezuelan capital.

Johnny Paredes of Peru was a security guard and employee of a restaurant in Lima until he decided to become a self-employed street vendor selling fancy clothes in the mornings and food and beverages in the afternoons in the upscale neighborhood of Miraflores.

Mexican computer technician Jorge de la Teja works much longer hours in Mexico City than at his former job in a service company, but with forced telework increasing due to the COVID-19 pandemic, his clients and income have grown over the past two years.

In Latin America and the Caribbean, 140 million workers (51 percent of all employed people) work in the informal sector and have been strongly impacted by the pandemic. But, often working on the streets, they take the pulse of the crisis and take on new tasks or ventures to support their families.

Since the pandemic broke out in March 2020, 49.6 million jobs, both formal and informal, have been lost in the region, 23.6 million of which were held by women, according to data from the International Labor Organization’s (ILO) latest labor overview, published in February.

Informality “continues to be one of the most important characteristics of the region’s labor markets,” Roxana Maurizio, an Argentine labor economics specialist with the ILO, told IPS from the agency’s regional headquarters in Lima.

Studies by the Economic Commission for Latin America and the Caribbean (ECLAC) have shown that of the 51 percent of informal workers, up to 37 percent work in the informal sector of the economy, more than 10 percent in the formal sector and four percent in households.

In practice, one out of every two employed persons in the region is in informal employment, according to the ILO, and one third is self-employed, according to ECLAC.

The ILO considers informal employment to be all paid work (both self-employment and salaried employment) that is not registered, regulated or protected by legal or regulatory frameworks. For the workers who perform it, it adds, remuneration depends directly on the benefits derived from the goods or services produced.

Street vending is one of the expressions of labor informality that dominates many streets in the region’s large cities, as in this open-air market in Lima. CREDIT: Courtesy of Johnny Paredes

Faces behind the numbers

Paredes, 46, told IPS from Lima that “in my case it worked out better, because of the independence of having my own schedule and being able to shorten or lengthen it depending on how the workday turns out, and because on the street I earn between 25 and 35 dollars a day, double what I was paid in my previous jobs.”

De la Teja, 37, agrees and explains that in Mexico City he supports his family “comfortably, with regard to food and other day-to-day expenses, because I earn more than 2,000 dollars a month. But extra expenses, such as insurance, or traveling for vacation, are difficult.”

Martinez, a 50-year-old mother of two sons and three daughters and grandmother of three, works as a domestic and caregiver in the mornings and in the afternoons she helps run the family kiosk, the “Doris Burger”, with her husband and two sons.

At the kiosk she earns “about 30 or 35 dollars a day from Monday to Friday, and up to 50 on weekends. Much more than in the jobs I have had standing in front of a stove since I was young, and it’s also better because it brings in money for several members of the family.”

The situation is different for Wilmer Rosales, a 39-year-old “todero” or jack of all trades in Barquisimeto, a city 350 kilometers west of Caracas, who said that “here in the interior (of the country) there is almost nothing to do and when there is, the pay is very low – two, three, or five dollars for a day’s work, at the most.”

Home delivery of food and other products has become a source of informal sector work in Latin American cities, in a sector driven by the COVID pandemic. CREDIT: ILO

Recovery with fewer jobs

In its February report, the ILO showed that the region’s 6.2 percent economic growth in 2021 was insufficient for the labor market to recover, and the regional unemployment rate stood at 9.6 percent.

Of the 49 million jobs that were lost at the peak of the crisis, in the second quarter of 2020, 4.5 million have yet to be recovered, the vast majority of them jobs previously held by women. And in total there are some 28 million people looking for work.

After the onset of the pandemic, the crisis manifested atypically and instead of affecting more formal occupations, there was a greater loss of informal jobs, leaving millions of people without an income.

In Argentina, Mexico and Paraguay, for example, the reduction in informal sector jobs accounted for more than 75 percent of the fall in total employment during the first half of 2020. In Costa Rica and Peru the proportion was somewhat lower, 70 percent, while in Brazil and Chile it was around 50 percent.

The situation has now been reversed, and the countries with available data indicate that between 60 and 80 percent of the jobs recovered up to the third quarter of 2021 were in the informal sector.

Among the factors favoring recovery of the informal sector are the destruction of formal sector jobs due to the pandemic, the greater ease of interrupting an informal salaried relationship, its greater incidence in small businesses and enterprises, as in the case of Martinez, and the impossibility of many informal workers to do telework.

Women are lagging behind in this recovery, due to their greater presence in sectors strongly affected by the crisis that are rallying slowly, such as hotels and restaurants. In highly feminized sectors, such as domestic service work, the rate of informality exceeds 80 percent.

Nor is informality benign to young people, who face greater labor market intermittency, explained in part by the intense inflows and outflows of the labor force; and greater labor instability is associated with their prevalence in informal, precarious, low-skilled activities.

Telework is an informal work option that has thrived during the COVID-19 pandemic in Latin America and is a refuge for women, who were especially hard-hit by the abrupt drop in employment during the confinement and shutdown of non-essential activities at the beginning of the health crisis. CREDIT: ILO

Leave no one behind, especially women

Against this backdrop, informality represents a challenge to the need and proposals in the region to produce, at the pace of the pandemic and as a way to overcome it, a sustainable and inclusive recovery, “leaving no one behind”, as the mantra already embedded in the discourse of various international organizations goes.

Maurizio is clearly committed to the formalization of employment. “Today, more than ever, the recovery needs to be people-centered; in particular, the creation of more and better jobs, formal jobs,” she said.

Informality “continues to be one of the most important characteristics of the region’s labor markets. Economic and social recovery will not be possible unless significant progress is made in reducing its incidence,” said the ILO specialist.

A necessary condition is “to advance in a process of economic growth with stability, reconstruction of the productive apparatus and persistent improvements in productivity.”

There must be, according to the expert, “a particular focus on the digital transition and young people; strengthening of labor institutions such as, for example, the minimum wage; care policies that allow women to return to and remain in the labor market; and support for small and medium-sized enterprises.”

Maurizio also called for the extension of unemployment insurance, social protection policies and “income guarantees for the population that continues to be strongly affected by the crisis.”

The gender perspective takes on “a central relevance in the recovery, taking into account the fact that of the 4.5 million jobs still to be recovered, 4.2 million are in traditionally female occupations.”

Among other measures, it is necessary to “facilitate the return of women to the labor market through a policy of investment in comprehensive care services with greater coverage, which at the same time should be a source of formal employment. Also, to support the recovery of economic sectors with a high female presence.”

Precarious working conditions have been a characteristic of informality associated with poverty in Latin America. CREDIT: Marcello Casal/Agência Brasil

Unions for a new working class

In the world of the trade unions, Brazilian Rafael Freire, secretary general of the Trade Union Confederation of the Americas (TUCA), added the challenge of “having a trade union for today’s working class, which in large part is precarious, outsourced, or working from applications.”

This workforce, “without job contracts, is increasingly part of the informal sector, in large proportions, for example 70 percent in Honduras and 80 percent in Guatemala,” said the leader of the 55 million-member central trade union from its headquarters in Montevideo.

Informality, which is structural in the Latin American social and labor panorama, is a major hurdle for economic recovery and social justice in the region, and while governments design strategies, define policies and take measures, millions of informal workers rely on their resilience to bring home food for their families.

Faces of a group of domestic workers in Brazil, during a meeting of one of their unions – a reflection that they are mostly black and poor. They have been fighting for decades for their labor recognition and rights. Today they are organized in 22 unions in states or municipalities and, since 1997, they have a national federation that represents them. CREDIT: Trabalhadoras Domésticas/Flickr

By Mario Osava
RIO DE JANEIRO, Feb 24 2022 (IPS)

“Woman, poor, black and illiterate” – most domestic workers suffer quadruple discrimination in Brazil, which made them more vulnerable to the COVID-19 pandemic, says one of their leaders, Gloria Rejane Santos.

President of the Paraíba Domestic Workers’ Union for the past 12 years, she found herself out of work after coronavirus appeared on the scene.

Of the 6.2 million domestic service jobs in Brazil in 2019, 1.5 million were lost in 2020, estimated Hildete Pereira de Melo, an economics professor at the Federal Fluminense University who has been researching gender and economics for four decades.

Vaccination against COVID-19, which began in January 2021, made it possible to recover only part of the lost jobs.

Paraíba is one of the nine states of the Northeast, Brazil’s poorest region, which is home to 4.06 million of the country’s 214 million inhabitants.

In its largest inland city, Campina Grande, population 415,000, police and labor inspectors freed a woman on Feb. 2 who was working in a home under slavery-like conditions including overwork, unhealthy conditions, rarely being allowed to leave the workplace, and no labor rights.

Helping her colleagues and combating discrimination against domestic workers, who are overwhelmingly black women, is the mission of Gloria Rejane Santos, president of the Domestic Workers Union of Paraíba, a state in Brazil’s poor Northeast region. CREDIT: Courtesy of Santos

Lingering slavery

“The pandemic aggravated the continuation of slavery,” Santos told IPS from João Pessoa, the capital of Paraíba, a city of 825,000 inhabitants, where two cases of slave labor were discovered and are still under investigation, she said.

Modern-day slavery in Brazil tends to be a more rural phenomenon. There were 1937 workers rescued from slavery conditions in 2021, almost all of them in the countryside of the Brazilian hinterland.

“Many employers demanded that their domestics stay at work all the time,” fearing that they would bring coronavirus back and forth to their homes. “The day laborers who could not accept it, we lost our jobs,” Santos said, referring to live-out domestic workers.

The pandemic thus created conditions for a return to work without time limits, without time off, and with a greater violation of labor rights, which have never been well-respected in domestic work.

The domestic labor market has changed since the 1980s. Live-in maids who worked an unlimited number of days have disappeared, as have domestics who work exclusively for one employer with a monthly salary.

There was an increase in the number of domestics who lived in their own homes and were hired for a limited number of days, who were more autonomous, in a process that accompanied advances in society, with new technologies and new habits, such as eating out more frequently, Melo noted. In addition, homes have become smaller and have lost the “maid’s room,” she said in an interview with IPS in Rio de Janeiro.

Domestic workers from Paraíba, a state in the Northeast region of Brazil, hold a protest organized by their union demanding respect for their rights and compliance with the laws that regulate their activity in the country. CREDIT: STDP

Female and informal

But informal employment is predominant. Nearly 70 percent of domestic workers do not have an employment contract. As a result, they do not have legal rights and are subject to the employer’s discretion, which has facilitated dismissals during the pandemic.

Their vulnerability is aggravated by the fact that 92 percent are women and 66 percent are black women, according to data from the Brazilian Institute of Geography and Statistics in 2019, the year before the outbreak of the COVID pandemic.

Domestic workers’ trade unions have included the feminine form of the word “workers” – trabalhadoras – in their names, recognizing the overwhelming majority of women in the sector.

Santos, despite presiding over the union, was left without regular work as a day laborer throughout the pandemic, as were “more than half of the domestic workers in Paraíba,” she estimated.

Getting by

Work in the trade unions is voluntary. It only offers limited per diem income from a few sponsored projects, generally for the training of female workers, but “lately we don’t even get that,” lamented the 64-year-old trade unionist, who has six grandchildren and one great-grandchild.

In the last two years she has survived on food basket donations and the emergency aid that the government granted to the poorest of the poor, worth 600 reais (about 115 dollars) in 2020, reduced by half during 2021, when it was only made available for a few months.

“I managed to get it after much struggle, with the support of the Public Prosecutor’s Office, because I was registered as a town councilor, although I was an unelected candidate,” said Santos.

She attributes her decision to accept the presidency of the union to her “vocation”. “I am the daughter of a domestic worker, I suffered a lot watching my mother work hard for scraps of food, some clothes or shoes,” she said.

When she became a trade union leader at the age of 52, she decided to go back to school, and completed primary and middle school. Going to school with adolescents was very difficult, she said, as she was rejected as an “old woman”, especially when it came to group projects.

She then attended an adult education course for high school, where everything went well. But she did not make it into university, where she wanted to pursue a degree in social work. She has channeled that inclination at least partly into her union work.

During the pandemic, the union carried out a permanent campaign to collect food and aid for unemployed members. “We provided assistance to more than 400 families” at the João Pessoa headquarters and the subheadquarters in Campina Grande, she said.

The pandemic forced Roseli Nascimento to replace beef in her diet with chicken, eggs and legumes. A live-out domestic worker in Rio de Janeiro, she lost four of the five days she worked weekly in 2020 and only regained them in mid-2021, when her employers felt protected by the widespread vaccination against COVID-19. CREDIT: Courtesy of Nascimento

Rights

But her main ambition is to “fight discrimination and make society recognize the value of domestic work.” She pointed out that she receives almost daily complaints of mistreatment and other conflicts from her colleagues. In these cases she receives help from a lawyer who has been working with the union on a pro bono basis since 2019.

To illustrate, she cited the case of “a maid who came to the union in tears” after she was accused of having stolen one hundred reais (19 dollars) from her employers. She was saved by a phone call from a son of the family, who confessed to taking the money without telling his parents.

The marginalization suffered by domestic workers in Paraíba is probably stronger than in other states because in that state “90 percent of them are black women,” said Santos.

“I am black, poor and the daughter of a domestic, but since I have an active voice, I decided to use it for the collective good,” she said.

Roseli Gomes do Nascimento, a 60-year-old resident of Rocinha, one of the large, famous favelas or shantytowns of Rio de Janeiro, had slightly better luck than Santos. Also a live-out domestic worker, of the five days she worked during the week, she lost four at the start of the pandemic.

It was not until the middle of the following year that she was able to return to work five days a week, when a good part of the Brazilian population was vaccinated against COVID. Only one supportive employer had kept her continuously employed and even paid her for her day of work during three months in which, for health safety reasons, she stayed away from her employer’s home.

That small income and 115 dollars a month in emergency government assistance for one quarter of 2020 and a fourth of that for nine months of the following year were barely enough to survive on. She lives alone, as her two daughters are now on their own, with her six cats. “I used to have nine, but I gave three away,” she told IPS.

A drastic reduction in beef consumption, sometimes replaced by less expensive chicken and eggs, and a diet with more fruits and vegetables, as well as fewer outings, helped her to live on a reduced budget, with the advantage of losing “about eight kilos, without even dieting.”

Legislators and trade unionists celebrate the first anniversary of the constitutional amendment establishing the rights of domestic workers in Brazil on Apr. 2, 2014. CREDIT: José Cruz/Agência Brasil

Context

Domestic work employed 75.6 million workers, or 4.5 percent of all wage earners around the world, according to a 2021 report by the International Labor Organization (ILO).

Latin America accounted for 18 percent of these workers and Brazil for nine percent, a much higher proportion than the size of the population, which represented 7.4 percent of the total in the case of Latin America and 2.7 percent in the case of Brazil.

In other words, the region has a higher proportion of paid domestic work, a product of its history and slavery, noted economist Melo. Only 20 percent of Brazil’s 60 million families hire domestic workers, a privilege of the upper-middle and upper classes.

Patients attending Opiate Substitution Therapy at a clinic in the eastern Ukrainian region of Dnipropetrovsk. Credit: International HIV/AIDS Alliance in Ukraine.

By Pavol Stracansky
KIEV, Sep 3 2012 (IPS)

Despite pledges from governments across Eastern Europe and Central Asia to fight HIV/AIDS – one of the eight Millennium Development Goals – the region has the world’s fastest-growing HIV epidemic.

Punitive drug policies, discrimination and problems with access to medicines and important therapy are all driving an epidemic which is unlikely to be contained, world experts say, until governments in countries with the worst problems change key policies and approaches to the disease.

Daniel Wolfe, director of the International Harm Reduction Development Programme at the Open Society Foundations, told IPS: “In most post-Soviet countries, where HIV remains concentrated among injecting drug users, harsh policies and discrimination in healthcare settings continue to cripple the AIDS response.”

Figures showing the extent of the region’s problems with the disease make grim reading. According to the World Health Organisation (WHO), while HIV infection rates are actually falling globally, Eastern Europe and Central Asia (EECA) is seeing the reverse.

The WHO says that there were 170,000 new HIV infections in the region in 2011. New infections have risen 22 percent in the EECA since 2005, and there is no sign of a slowdown.

Injection drug use has been identified as fuelling the epidemic – accounting for up to 70 percent of new infections, according to the WHO.

Activists say the key to tackling the epidemic lies first and foremost in combating the injecting drug use problem, but that official and unofficial stances towards drugs and their users are stopping the problem being effectively tackled, or are even making it worse.

Dasha Ocheret of the Eurasian Harm Reduction Network, told IPS: “Punitive drug policies have to be stopped. People are afraid to get treatment for fear of criminal prosecution or problems with the police in other forms and there are situations where people would rather risk getting HIV than go somewhere like a needle exchange centre.”

Russia and the Ukraine are widely seen as facing the greatest problems, with official policies in the former being blamed for hindering the fight against HIV/AIDS in other countries in the region too.

Opiate-substitution therapy (OST), a treatment for drug users in which methadone or buprenorphine are provided to heroin users, which is standard practice in much of the rest of the world, is banned by law in Russia. Public promotion of its use is punishable by jail.

Critics of methadone treatment in Russia argue that it keeps patients in addiction, while others claim western countries want the treatment offered in Russia for commercial gain. They also warn that methadone would probably end up being sold on the black market, sparking another drug problem.

But with Russia emerging in recent years as a major donor in the EECA region, it is also exporting its policies, including on OST, along with its money, and there are fears this could lead to OST programmes being shelved or restricted in other states.

“Russia is a serious regional player and its policy on drugs, like its policies on other drugs, influence policies in other countries in the region,” said Ocheret.

UNAIDS officials have publicly said that the spread of HIV among injecting drug users could be largely stopped if OST, combined with needle exchange programmes, were offered.

This is a view backed up by groups such as Harm Reduction International, which told IPS that huge differences – up to 30 percent – in prevalence rates of HIV among injecting drug users in western countries and Russia is down to the provision of OST and needle exchange programmes.

But even in EECA countries where needle exchange and OST schemes are on offer, there are often serious problems with access to them.

In many EECA countries government officials continue to question their effectiveness and refuse to support them financially, leaving programmes relying on donor support.

This can limit the coverage, scale and subsequent effectiveness of such programmes, and, because such funding is rarely indefinite, creates fear among those on them that their access to OST could be suddenly cut off if a programme closes.

But a greater problem is the active persecution of those trying to access schemes.

Many drug users across the region, where lengthy jail sentences for possession of even the tiniest amounts of drugs – for instance the residue in a used syringe handed in at a needle exchange centre – are the norm, have reported being beaten, tortured, blackmailed or even falsely imprisoned by police.

A spokesman for the International HIV/AIDS Alliance in Ukraine, where OST and needle exchange schemes ostensibly have government backing, told IPS: “Physical and other intimidation towards drug users is routine police practice.

“Drug users, sex workers, and service providers have spoken of how police have extorted money and information from drug users through severe beatings, electric shocks, partial suffocation with gas masks, and threats of rape.

“They have also reported that police planted drugs in their homes or on their persons, and used this as evidence to arrest or abuse them.”

Discrimination of drug users also extends to the provision of antiretroviral (ARV) drugs.

The International HIV/AIDS Alliance in Ukraine told IPS that denying drug users ARV drugs was a “common problem”, although there is no way of officially proving it.

The Eurasian Harm Reduction Network also told IPS similar incidents had been reported in Russia.

The WHO estimates that only 23 percent of people who are eligible for HIV drugs in the EECA actually receive them. The figure in sub-Saharan Africa is more than double that.

Local groups working to combat the disease say until Western healthcare approaches to HIV/AIDS treatment and prevention are adopted, the region is unlikely to get the epidemic under control.

Ocheret told IPS: “Countries like Poland, for instance, introduced western healthcare practices on HIV/AIDS, including OST, in the 1990s when it had a difficult problem with HIV/AIDS and by doing so managed to get the problem under control.

“In many EECA countries these programmes remain in perpetual ‘pilot’ stages and have never developed further.”